Canadians want choice in how they access health care: poll

According to a new poll, most Canadians favour a mixed system of health care that allows them to purchase services in the private sector — but they still want a non-profit system.

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OTTAWA — The majority of Canadians support a "mixed" model of health care that would give them the option of spending their own money for care in a private system, according to the results of a new poll.

And three-quarters of them support being able to buy private health insurance for all forms of medically necessary treatment, including cancer care and heart surgery, which they could then obtain outside of the public health care system.

The numbers show up in a new poll conducted by Ipsos Reid for Postmedia News and Global Television as part of a sweeping set of questions examining the state of Canadian values as we approach the Canada Day weekend.

"Canadians are saying, 'I want an extra layer of protection, that I can buy health insurance on top of what I've got, and I should have the right to do that'," said John Wright, the senior vice president of Ipsos Reid.

"If you can wait in line, the quality's OK. What Canadians want is the option to go up the elevator."

Canada's national health insurance program reaches its 50-year milestone on July 1. In 1962, Saskatchewan introduced the first public health care program.

In recent years, the very health of the system has come into question and there has been persistent debate about whether the federal government should allow the emergence of a "mixed" model in which the non-profit public system and for-profit private system operate side-by-side to give patients greater choice.

Advocates say this reform would ease backlogs in the public system and provide greater choice to people facing long waits for care, while critics say it would exacerbate a two-tier system in which Canadians with money get better treatment. Canadians currently can spend privately on many health services, but the poll suggests they'd like to broaden this choice.

Prime Minister Stephen Harper's government has professed its support for the public system, but has made it clear it will not interfere with how provinces run their health care systems.

In its poll, Ipsos Reid asked Canadians which system of funding they primarily support when given the option between a for-profit model, a not-for-profit model and a mixed model of both profit and non-profit.

It found that 53 per cent preferred the mixed model.

When asked to what extent they'd support or oppose the idea of Canadians being allowed to buy private health insurance for all forms of medically-necessary treatment that could then be obtained outside of the current system, including cancer care and heart surgery, 76 per cent supported the idea.

But, when only given a choice between a not-for-profit and a for-profit model, four out of five (80 per cent) Canadians said they preferred a not-for-profit model of health care — up nine percentage points since 2006.

At the end of the day, Canadians are hesitant to give up the values inherent in medicare, said Dr. Michael Rachlis, one of Canada's leading medical policy analysts and consultants.

Canadians, particularly those outside of Quebec, have a fragile national identity, Rachlis said, and medicare is one way to clearly differentiate us from the United States.

"Medicare becomes an important symbol to show that we are different from the Americans and that, in the United States, people are prepared to let other people die because they don't want to pay for their medical care and in Canada, we're different," Rachlis said. "We care more about each other."

Canadians are anxious about whether they will be able to get the care they need when they need it, but most aren't aware of the options already available to them in the public system, Rachlis said.

"You can't ask for it if you don't know what's on the menu," Rachlis said.

Public sector innovations are being developed across the country every day, Rachlis said, but they tend not to get attention, or don't catch on, or people don't know much about them.

For example, an advanced access technique used in a number of family medicine practices across Canada is cutting wait times in those practices dramatically, Rachlis said, and a model in Hamilton, Ont. that integrates psychiatrists into family doctor practices is improving access to those specialists.

"If that were done for all specialists we would have virtually no wait for specialty care in this country," Rachlis said.

In the poll, Canadians were split on whether or not doctors should be allowed to work in a private system, with 46 per cent saying they support doctors being permitted to work in a private system, and 54 per cent opposing it.

The poll interviewed a sample of 1,101 Canadians between June 20th to 25th. Weighting was employed to balance demographics.

A survey with an unweighted probability sample of this size and a 100 per cent response rate would have an estimated margin of error of +/- 3.0 percentage points, 19 times out of 20, of what the results would have been had the entire population of adults in Canada been polled.

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